Life brings with it difficult moments such as the loss of a loved one, disappointment or betrayal. Psychological pain is, in fact, a condition that sooner or later affects anyone. It is not an official diagnostic term, but is used to describe pain that can be attributed to psychological factors, which can include certain beliefs, fears, memories or emotions that we detect at the beginning or worsening of pain.
With this Psychology-Online article, we are going to try to make a summary of the topic, addressing psychological pain to understand what it is, the different types and how we can treat it.
What is psychological pain
Thinking of pain as psychological means assuming that it has a purely psychic origin. Psychological pain is the experience of mental discomfort, feeling unpleasant and painful emotions. Although it can also be a pain with a physical sensation, but with a psychological origin.
Let’s look at the psychic causes of pain. Psychological pain is caused by a stimulus, also psychic, which could be a dream, a hallucination or a memory. This does not mean that psychological pain is a dream, or a hallucination, or a memory, but it only means that such pain can derive from a mechanism similar to that which results from an event. considered only of psychic origin like a dream.
Psychological pain can also be explained in a process of identification; This can occur, for example, when a subject loses a loved one who has suffered greatly.
On the other hand, psychological pain can also refer to psychogenic pain or somatic pain. Complex to define, even more difficult to treat, Psychogenic pain remains a challenge for contemporary medicine from the pathophysiological and therapeutic point of view. The MDE IV definition of “algic disorder” best reflects the clinical characteristics of this phenomenon, among the many nosographic definitions that have occurred in the last 30 years.
The pain disorder
Over the years, and with the expansion of knowledge about pain, psychological pain has found and changed different definitions and diagnostic criteria; What best reflects its characteristics seems to be the MDE’s definition of pain disorder, a psychological diagnosis that best fits that of psychological pain.
It is registered in the chapter of the somatoform disorders, but it is little used in clinical practice; a diagnosis that can be used when pain represents the main component of the clinical picture and generates clinically significant discomfortlimiting, in the absence of pathological psychic conditions but in the presence of some psychological factor that plays a determining role in the onset, implementation or maintenance of the pain itself.
In the following article, you will find more information about .
Types of pain and duration
Pain, being a personal experience, is subjective and not easily quantifiable, but we can distinguish different types according to their duration:
- Sharp. The sensory component seems more important; It usually disappears with repair of the damage.
- Chronic. Affective and evaluation factors become more important, associated with profound changes in personality and lifestyle.
- Transient. Disappears with the end of the stimulus.
- Recidivist. Repetitive psychological pain.
- Persistent. Permanence of the nociceptive stimulus.
Psychological pain is complicated to manage and must be approached from several perspectives. In the next section, we will see how to treat psychosomatic pain.
How to recognize psychological pain
Let’s now look at some elements that frequently coincide, often in combination, in patients with pain with a psychological component:
- History of illness in a family member or acquaintance with symptoms similar to those of the patient.
- History of child or adult abuse. In this article, we talk in depth about the .
- History of “multiple allergies” and medication intolerance.
- History of somatoform symptoms or medical conditions of questionable nature.
- History of futile, invasive therapeutic attempts with iatrogenic damage.
- History of forensic litigation with absence in the history of psychiatric pathology.
Clinical features
- Pain that starts suddenly and grows over time.
- High-intensity, qualitatively variable pain that is not modified by posture, movement, or circadian variability.
- Lack of response or only transient response to analgesics.
- Choice of location and type of symptom with a symbolic background.
- Existence of a serious disability, disproportionate to clinical objectivity.
- Negative diagnostic tests or clear disproportion/inconsistency between the evidence of pathology and the clinical picture.
- Presence of sensory and motor disorders associated with the “non-anatomical” distribution.
Behaviors and convictions
- Conviction of having an organic pathology and rejection of possible psychological or psychiatric interpretations.
- Presence of defensive attitude, anger and great criticism of the antecedents.
- Omission of documents and medical information that support psychogenicity.
- Description of symptoms and disability with intense emotional involvement.
- Exaggerated pain behavior in the presence of “sensitive” people (healthcare workers, spouses and family members, colleagues and employers).
- Incongruence between high pain estimation and very poor or absent pain behavior.
- Manipulative behavior towards the environment to ensure primary and secondary advantages.
- Phenomenon of doctors shopping (spasmodic search for a new specialist who can finally understand the pain to resolve it, with great expenditure of time/money and risk of iatrogenic damage), with collection of enormous medical documentation.
- Unemployment and lack of motivation to return to work.
How to treat psychological pain
How to remove psychological pain? Psychological pain is not an invention, it is not madness, but rather it must be the starting point to recognize a real situation of suffering. The person must, above all, feel understood in a way that accepts and legitimizes the discomfort as such and then be able to embark on a treatment path.
How to cure psychosomatic pain? In recent years, studies on chronic pain have shown that multidimensional treatment is extremely effective as a strategy in patient treatment. On the one hand, a psycho-rehabilitative treatment, on the other, pharmacological treatment. Let’s look at the treatment options for psychosomatic pain:
- The psychological interventions such as , or with hypnosis or simply a supportive intervention, have notable effectiveness in nocicion.
- The physical therapies (acupuncture, magnetotherapy, electroanalgesia, etc.) and pharmacological therapies performed with analgesics, neuromodulators or psychotropic drugs, they also manage to have significant effectiveness on psychosocial aspects of pain.
- He pain management Psychological may be similar to that of chronic pain. However, in this type of multidimensional approach to patients with psychological pain, it is necessary to carefully evaluate the use of medications and therefore avoid those that have a high potential for abuse, such as opiates and benzodiazepines, which can lead to addiction. .
The simultaneous use of several techniques is essential for effective multidimensional management.
This article is merely informative, at Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
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Bibliography
- Gianfrancesco, F. (2020). Psychogenic pain. Retrieved from: https://www.nurse24.it/dossier/dolore/dolore-psicogeno.html
- Vendramini, M. T. (2007). Oltre l’evento. The death in the educational relationship. Milan: Franco Angeli.